How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $213.80 Median $239.88 Typical High $7,244.36 | Facility | None | $213.80 | $239.88 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $223.87 Typical High $446.68 | Professional | None | $190.55 | $223.87 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $2,187.76 Typical High $3,388.44 | Facility | None | $891.25 | $2,187.76 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $263.03 Typical High $380.19 | Professional | None | $229.09 | $263.03 | $380.19 |
Highmark BCBS Setting Facility Modifier None Typical Low $5,370.32 Median $5,370.32 Typical High $5,888.44 | Facility | None | $5,370.32 | $5,370.32 | $5,888.44 |
United Setting Facility Modifier None Typical Low $912.01 Median $1,258.93 Typical High $2,570.40 | Facility | None | $912.01 | $1,258.93 | $2,570.40 |
United Setting Professional Modifier None Typical Low $194.98 Median $257.04 Typical High $501.19 | Professional | None | $194.98 | $257.04 | $501.19 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $89.13 Median $107.15 Typical High $120.23 | Professional | 52 · Reduced service | $89.13 | $107.15 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $42.66 Typical High $47.86 | Professional | 53 · Discontinued | $35.48 | $42.66 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $158.49 Typical High $181.97 | Professional | 54 · Surgery only | $134.90 | $158.49 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $31.62 Typical High $36.31 | Professional | 55 · Aftercare only | $26.92 | $31.62 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $21.38 Typical High $23.99 | Professional | 56 · Pre-op care only | $17.78 | $21.38 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $147.91 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $125.89 | $147.91 | $169.82 |
Where Delaware sits
The same service costs 4.6 times more in Oklahoma than in Utah. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Delaware· 42nd of 51
$269
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.